Laparoscopic Magnetic Sphincter Augmentation Device Using the Linx System

Abstract

Indications-Symptoms of GERD refractory to maximal medical management-Intolerance of anti-reflux medications due to side effect profile-Unwillingness to sustain polypharmacy acid suppression regimen to control symptoms-Complications from poorly controlled reflux including Barrett's esophagus, erosive esoph-agitis, and esophageal strictures Essential Steps 1. Appropriately position and anchor patient to the operative table to allow for steep reverse Trendelenburg, supine and split-leg position. 2. Thoughtfully position five trocars to allow visualizing and accessing the esophagus. 3. Dissect the esophagus and preserve the phren-oesophageal ligament and hepatic branch of the vagus nerve. 4. Mobilize posterior vagus off the esophagus. 5. Consistently and accurately size the esophagus with manufacturer-provided sizing device. 6. Position the MSAD and lock it in place. Complications